Abortion Rights Backers Threaten Primaries, 'No' Votes on Health

There's nothing like a painful, unexpected defeat to focus the mind and, potentially, the money. For supporters of abortion rights, that moment arrived when the House added to its historic health bill an amendment that would limit abortion coverage and those who can buy it. Anger, frustration and threats are in the air.

It's too early to say whether the abortion rights lobby is a sleeping giant, but it is definitely, some would say finally, awake. Nancy Keenan, president of NARAL ProChoice America, was in a fighting mood in an interview on Monday. "There's elections coming up in 2010. We will know who stood with us and who stood against us," she told me. The latter, she said, may face primary challenges. "Nothing's off the table," she said. "It's a new day and I'm here to tell you we're going to hold those accountable who voted against us." This would be a departure. According to Keenan, her group has supported a challenger in a Democratic primary only once.

Dozens of House members are vowing in a letter to House Speaker Nancy Pelosi to vote against any final House-Senate compromise that contains the new abortion restrictions. Rep. Diana DeGette, D-Colo., is continuing to gather signatures on the letter, which calls the language "unprecedented and unacceptable." In the hour after the Saturday night vote, she told me, more than 40 people signed on -- enough to sink the final bill. "People were mad," she said.

Two major studies show that most Americans now have coverage for abortion services. The House bill as introduced included a carefully negotiated compromise involving a new competitive insurance marketplace, or exchange, for the self-employed and the uninsured. If they received federal subsidies to help them pay for plans, that money would be segregated and used for services other than abortion. Thus the new health bill would comply with the Hyde Amendment that bars federal funds for abortion.

But on the floor Saturday night, the House substituted a more restrictive amendment sponsored by Michigan Democrat Bart Stupak. It says people who buy insurance through the exchange, and use subsidies to help them do it, would not be allowed to buy a policy that covered abortion. Abortion rights advocates say most insurance companies, trying to sell the most policies to the most people, would stop offering abortion coverage on the exchange. "Millions of women would lose private coverage for abortion services and millions more would be prohibited from buying it even with their own money," Laurie Rubiner, vice president of public policy at Planned Parenthood, wrote in a memo Monday.

Liberal blogger-activist Jane Hamsher has repeatedly scored abortion-rights groups in the past few days as passive and ineffectual. Stupak first went public with his plans in July, Hamsher told ABC on Monday, but defenders of abortion rights were asleep at the wheel. "They've been ready to roll on this for a long time. It wasn't a surprise," she said. "The only people it apparently surprised are NARAL and Planned Parenthood."

Rubiner blames the collapse of the earlier House agreement on abortion on 11th-hour "intimidation tactics" by Catholic bishops, including robocalls and requirements that priests give sermons on the issue. "It was pretty shocking," she told me. "This was their no. 1 priority. Not getting health care to immigrants or low-income women or children. Their no. 1 priority was restricting abortion for middle class women."

DeGette says she doesn't blame the groups and says no one was asleep at the wheel. She calls Stupak a friend and says she worked with him all summer to come up with a compromise they both could live with. When that didn't work out, she said, she huddled with other Democrats against abortion to come up with the language that ended up in the bill, called the Capps amendment. What happened Saturday night was a procedural ambush, she said: Stupak and his allies kept changing their demands until Pelosi was forced to offer them a vote on their amendment or risk losing the whole historic bill.

"She was beside herself. She was so upset. She worked so hard for two days to stop this. But the problem was they kept moving the goalpost," DeGette told me. "The speaker had a terrible choice put to her. I saw the list. She did what she had to do to move the bill forward. But she is also adamantly opposed to including this in the final bill."

The House advocates got a bit of backup Monday night from Obama, who signaled that he doesn't want the Stupak amendment in the final bill. "There needs to be some more work before we get to the point where we're not changing the status quo," he told ABC News.

The Senate is more conservative than the House in some ways. But abortion politics are so complicated and confounding that chances are decent that the Stupak amendment won't make it into the Senate bill.

There are, says Keenan, 186 abortion-rights supporters in the House and 218 members who are anti-abortion. The other 31 are in the middle -- supportive of family planning and sex education but open to restrictions on abortion. In the Senate, Keenan gives the count as 41 backers of abortion rights, 40 against abortion, and 19 mixed.

The more even Senate split is encouraging to backers of abortion rights, as are Senate rules that mean it would take 60 votes to add a Stupak-style amendment to the bill. On the other hand, its presence in the House bill means it will be present in the House-Senate conference committee tasked with drafting a final compromise. "Getting it stripped out of conference is going to be incredibly difficult," Hamsher said disapprovingly. "You don't start your battle after the bill has passed."

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